Updating Canada's diagnostic coding system for physician billing: Exploring family physician perspectives of ICD-11...

Area of Science:

• Health Informatics
• Medical Coding Systems
• Primary Care Research

Background:

• Accurate medical coding is crucial for healthcare data analysis and reimbursement.
• The International Classification of Diseases, 9th Revision (ICD-9) has been the standard, but limitations have prompted the development of newer systems.
• Assessing physician perspectives on coding systems is vital for successful implementation.

Purpose of the Study:

• To compare family physician usage and perceptions of the International Classification of Diseases, 11th Revision (ICD-11) and the International Classification of Primary Care, Version 3 (ICPC-3) against the current ICD-9.
• To evaluate the efficiency and user experience of different medical coding systems in a primary care setting.

Main Methods:

• A cross-sectional, pre-implementation study was conducted in Canada.
• 161 family physicians participated in a mixed-methods study involving a patient vignette coding exercise and a post-coding survey.
• Coding speed, consistency, and physician satisfaction were assessed for ICD-11, ICPC-3, and ICD-9.

Main Results:

• Physicians coded significantly faster using ICPC-3 (median 48 seconds) and ICD-11 (median 59 seconds) compared to ICD-9 (median 57 seconds).
• Coding consistency did not differ significantly across the three systems.
• Both ICD-11 and ICPC-3 were rated more positively than ICD-9 for comprehensiveness, ease of use, and ability to capture medical and social complexity.

Conclusions:

• ICD-11 and ICPC-3 demonstrated superior utility and a more positive user experience for family physicians compared to ICD-9.
• These findings provide a basis for future discussions on enhancing medical coding systems in Canada.